Hiperplasia de la úvula: presentación de un caso clínico / Hyperplasia of the uvula: report of a clinical case

La hiperplasia de la úvula es una entidad poco frecuente. Puede tener diversas causas, tales como: surgir a partir de un proceso infeccioso; por reacciones alérgicas; angioedema hereditario (HANE) (14,16); inhalación de sustancias psicoactivas (7); traumatismos ocasionados por procedimientos como intubación o extubación endotraqueal, así como durante la aspiración de los líquidos de la cavidad oral en procedimientos quirúrgicos. (7,14,16) El alargamiento de la úvula, en algunos casos, se manifiesta asintomático. Este trabajo tiene como objetivo la descripción de esta entidad, la presentación de un caso clínico, y su manejo clínico-quirúrgico (AU)

The hyperplasia of the uvula is a rare entity, it can have diverse causes, such as: of an infectious process, allergic reactions, hereditary angioedema (HANE), (14 16) inhalation of psychoactive substances (7) traumatisms caused by procedures such as, intubation or endotracheal extubation, as well as during the aspiration of liquids from the oral cavity in surgical procedures (7,14,16). The lengthening of the uvula, in some cases, is asymptomatic. The aim of this work is the description of this entity, the presentation of a clinical case, and the clinical and surgical management (AU)

Haemophilia B in Five Nigerian Siblings

Aim: To highlight the diagnosis of haemophilia B in 5 Nigerian brothers as well as the diagnostic and management challenges inherent in resource-poor settings. Presentation of Cases: We report the cases of 5 brothers with ages ranging from 2 years to 13 years seen at the paediatric out-patient unit of the Federal Medical Centre Azare, Nigeria. They presented with complaints of abnormal and excessive bleeding since the neonatal period. Bleeding was often provoked by events ranging from traditional uvulectomies, dental exfoliation to circumcisions and was severe enough to require blood transfusions in some instances. Following diagnosis, genetic counseling was offered to the family and plans put in place to commence administration of prophylactic factor IX concentrate. Discussion: The peculiarity in these cases is the large number of affected individuals in one family. This is made more remarkable by the fact that haemophilia B (HB) is extremely rare in Nigeria. The reason for the relative rarity of HB in Nigeria is not known. However, it is recognized that the genetic mutations associated with HB are diversely distributed and often show variations between and across ethnic groups. This may account for the spread and variability in clinical manifestations of the disease. Conclusion: Haemophilia B though very rare may cluster in individual families. The unavailability, as well as the high cost of coagulation factor concentrates in resource-poor settings remains a significant challenge for physicians and patients alike.

UVULECTOMY AND OTHER TRADITIONAL HEALING PRACTICES: TRADITIONAL HEALERS' PERCEPTIONS AND PRACTICES IN A CONGOLESE REFUGEE CAMP IN TANZANIA

Little is studied about traditional healers‘ perceptions toward and practice of uvulectomy, which is known as a traditional surgical practice mainly in Africa and which sometimes results in severe complications. This study aimed to clarify the perceptions toward and practice of uvulectomy and the other traditional healing practices of traditional healers in a Congolese refugee camp in Tanzania. Interviews were conducted with 149 traditional healers, comprised of 59 registered, 68 non-registered and 22 faith healers. A total of 1.7% of the registered healers and 8.8% of the non-registered healers had ever conducted uvulectomy on children (a median of 2 months to a median of 3 years of age) and had received cash or domestic fowls equivalent to US$1-3 per operation. Although over 80% of the respondents believed traditional treatments to be more effective than modern medicine, less than 20% considered uvulectomy beneficial and in fact about 40% considered it to be harmful. The respondents raised cough, vomiting, appetite loss and other symptoms as an indication for uvulectomy, and death, bleeding, throat pain and other symptoms as harmful effects associated with uvulectomy. In this camp, the healers also performed other surgical procedures, such as male and female circumcision, tattoos and scarification. In conclusion, only a limited number of the traditional healers believed that uvulectomy is beneficial and performed it on infants and young children, and these were mainly non-registered healers who had relatively little collaboration with modern health professionals. In refugee settings where modern health professionals might not be familiar with traditional healing, it is considered crucial to assess the risks of ongoing traditional practices and to strive to achieve more strategic communication between modern and traditional health providers.